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Indiana rates for HCPCS L5658

Addition to lower extremity, socket insert, above knee (AK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $562 · 10th–90th $263–$5890%20%40%10th90th$562Professionalmedian $263 · 10th–90th $200–$3980%20%40%10th90th$263$0.5$2.0$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $257.04 / $380.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $562.34 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $269.15 / $478.63
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $363.08 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $331.13 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $269.15 / $389.05